Nurses spend more time with patients than most other types of providers and have unique insight into patient care and the the healthcare system.

Fracking, Health, and the Environment: More Bad News

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

U.S. EPA / via Wikimedia Commons U.S. EPA / via Wikimedia Commons

Last month, Physicians for Social Responsibility and Concerned Health Professionals of New York released the third edition of their Compendium of Scientific, Medical, and Media Findings Demonstrating Risks and Harms of Fracking. This document summarizes more than 500 peer-reviewed studies on hydraulic fracturing (fracking),  along with many government and investigative journalism reports.

Fracking involves drilling into the earth and injecting a mixture of water, sand, and chemicals into the rock at high pressure to release the gas inside. There is extensive evidence to demonstrate health risks, environmental damage, and contributions to climate change caused by this practice.

The compendium is intended for policy makers, researchers, journalists, and the public. Specific fracking-related problems identified in this body of literature include the following:

  • Public health impacts, including respiratory disease and congenital abnormalities
  • Air pollution
  • Water contamination
  • Soil contamination and its effects on agriculture
  • Radioactive releases
  • Inherent engineering problems
  • Occupational health and safety hazards
  • Impacts from fracking-associated infrastructure, including noise, light, and diesel pollution
  • Earthquakes and seismic activity
  • Climate change (primarily from methane leaks)

[…]

Thanksgiving in the ICU: Woven into the Tapestry of Traditions

By Marcy Phipps, BSN, RN, CCRN. Editor’s note: This post, originally published in 2011, remains as timely as ever. The author is now chief flight nurse at Global Jetcare.) 

cranberries

I’ll be working this Thanksgiving. I’ve worked so many Thanksgivings that the ICU feels woven into the tapestry of my own traditions. I don’t really mind; the cafeteria serves a fitting feast that’s embellished by the homemade treats we bring in, and although we won’t actually be watching it, the Macy’s parade will be on. Somehow, the smells and sounds I associate with the holiday will mix and mingle with the usual bustle of critical care, and it’ll feel like Thanksgiving. It’s actually a nice day to be at the hospital—for the nurses, that is.

For our patients and their families, I know hospital holidays fall far short. We have one patient, in particular, who’s been with us for a while. Her husband’s been a fixture at her side throughout her stay, and I expect to find him stationed there this Thanksgiving. Hospital turkey and television won’t give him the comfort or peace that he seeks, and I don’t know that he’ll be giving thanks. For many weeks I’ve watched him skirt a fine line between gratitude and despair; things could always be worse, but they could certainly be better.

When I stop to count my blessings, I’m overwhelmed. I belong to a profession that I’m passionate about—one that brings me great […]

Imagery: A Safe, Simple Practice Available to All Nurses

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

by Ramon Peco/via Flickr by Ramon Peco/via Flickr

“In our quest to keep up with the latest medical advances, we often forget that the healing art of imagery is available to each of us,” writes nurse practitioner Laurie Kubes in this month’s AJN. In “Imagery for Self-Healing and Integrative Nursing Practice,” Kubes explores some of the evidence supporting this technique and illustrates how it can enhance both patient care and our own self-care.

Imagery builds upon the quiet reassurance and support that we routinely provide to patients in our efforts to make them comfortable and relaxed. The more deliberate practice of imagery engages the power of imagination for deeper relaxation and a potentially more healing experience. And all we need in order to do this, as Kubes notes, is an open mind, a basic knowledge of the practice, and time to dedicate to it.
[…]

Top Health Story Picks of AJN Contributing Editors for 2015

By Diane Szulecki, AJN associate editor

Kelley Johnson by Disney | ABC Television Group via Flickr Nurse and Miss America contestant Kelley Johnson by Disney | ABC Television Group via Flickr

With the end of the year steadily approaching, AJN asked its contributing editors, editorial board members, and staff to share what they consider to be the most significant health care and nursing-related headlines of 2015 so far. Now it’s readers’ turn. See the top picks below and feel free to leave a comment to share your thoughts and additions to the list.

Clinical/Care Issues

  • The growing patient experience movement and the limitations of patient satisfaction measurements
  • The rise in chronic diseases due to lack of prevention efforts and unhealthy lifestyles
  • Substance abuse, including alcohol, prescription drugs, heroin
  • Vaccinations and issues regarding public trust of vaccines

Professional Issues

  • Nurses’ responses to critical comments made on The View and related ongoing discussion about the nursing profession’s image
  • Challenges and trends in nursing education: the shift toward advanced practice as a career path for many nurses and rapid growth in the number of DNP programs and applicants
  • Workplace stresses: staffing issues, moral distress, strain caused by an aging population with multiple comorbidities, plus an increase in the number of insured due to the Affordable Care Act

U.S Health Care and Health System Issues

Recognizing and Managing Late or Long-Term Complications in Adult Allo-HSCT Survivors

By Amanda Anderson, a critical care nurse and graduate student in New York City currently doing a graduate placement at AJN.

Everybody, myself included, thought he was going to die. Another nurse on another floor had administered his stem cell transplant a few weeks prior, but as his primary nurse I was now in charge of managing its aftereffects.

Ben (not his real name, and some details have been changed) was one of the many young patients I’d cared for who suffered from a violent course of complications following allogeneic hematopoietic stem cell transplant (allo-HSCT). Intractable diarrhea and skin sloughing led to graft-versus-host-disease’s usual sequelae: wounds, drug-resistant infections, looming sepsis. The walls of his bladder, scarred and irritated by the myriad of toxic drugs he’d been given, bled. One day, while I slept at home between night shifts, he lost so much blood that they rushed him to the OR. The treatment—never before performed—stopped the bleeding. But it left him in excruciating, around-the-clock pain.

Between regular doses of Dilaudid and PCA pump pushes, he cried out to me, “I can’t do this. I don’t want this anymore.” I couldn’t blame him—his cancer fight raged on endlessly. Watching his boyishly handsome face grimace with so much pain, I remembered other young allo-HSCT patients’ faces, some of them peaceful only in the postmortem.

As it turned out, Ben survived his ICU stay. I heard about his discharge to the bone marrow transplant unit after I returned from a vacation. I lost touch with him, in the […]

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